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脑血管功能障碍是中暑治疗中一个有吸引力的靶点。

Cerebrovascular dysfunction is an attractive target for therapy in heat stroke.

作者信息

Chen Sheng-Hsien, Niu Ko-Chi, Lin Mao-Tsun

机构信息

Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Taiwan.

出版信息

Clin Exp Pharmacol Physiol. 2006 Aug;33(8):663-72. doi: 10.1111/j.1440-1681.2006.04429.x.

DOI:10.1111/j.1440-1681.2006.04429.x
PMID:16895537
Abstract
  1. The aim of the present review is to summarize clinical observations and results of animal models that advance the knowledge of the attenuation of cerebrovascular dysfunction in the setting of heat stroke. It is a narrative review of selected published literature from Medline over the period 1959-2005. 2. All heat-stressed rodents, even under general anaesthesia, have hyperthermia, systemic inflammation, hypercoagulable state, arterial hypotension and tissue ischaemia and injury in multiple organs. These findings demonstrate that rodent heat stroke models can nearly mirror the full spectrum of human heat stroke. Experimental heat stroke fulfills the empirical triad used for the diagnosis of classical human heat stroke, namely hyperthermia, central nervous system alterations and a history of heat stress. 3. These physiological dysfunctions and survival during heat stroke can be improved by whole-body or brain cooling therapy adopted immediately after the onset of heat stroke. 4. However, in the absence of body or brain cooling, these heat stroke reactions can still be reduced by the following measures: (i) fluid replacement with 3% NaCl solution, 10% human albumin or hydroxyethyl starch; (ii) intravenous delivery of anti-inflammatory drugs, free radical scavengers or interleukin-1 receptor antagonists; (iii) hyperbaric oxygen therapy; or (iv) transplantation of human umbilical cord blood cells. 5. In addition, before initiation of heat stress, prior manipulations with one of the following measures was found to be able to protect against heat stroke reactions: (i) systemic delivery of alpha-tocopherol, mannitol, inducible nitric oxide synthase inhibitors, mu-opioid receptor antagonists, endothelin ETA receptor antagonists, serotoninergic nerve depletors or receptor antagonists, or glutamate receptor antagonists; or (ii) heat shock protein 72 preconditioning. 6. There is compelling evidence that cerebrovascular dysfunction is an attractive target for therapy in heat stroke.
摘要
  1. 本综述的目的是总结临床观察结果以及动物模型的研究成果,这些研究成果有助于增进我们对热射病时脑血管功能障碍减轻情况的了解。这是一篇对1959年至2005年间从Medline中选取的已发表文献的叙述性综述。2. 所有受热应激的啮齿动物,即使在全身麻醉状态下,都会出现体温过高、全身炎症、高凝状态、动脉低血压以及多器官的组织缺血和损伤。这些发现表明,啮齿动物热射病模型几乎可以反映人类热射病的全部特征。实验性热射病符合用于诊断典型人类热射病的经验三联征,即体温过高、中枢神经系统改变以及热应激史。3. 在热射病发作后立即采用全身或脑部降温疗法,可以改善这些生理功能障碍并提高热射病期间的生存率。4. 然而,在没有身体或脑部降温的情况下,通过以下措施仍可减轻这些热射病反应:(i)用3%氯化钠溶液、10%人白蛋白或羟乙基淀粉进行液体补充;(ii)静脉注射抗炎药物、自由基清除剂或白细胞介素-1受体拮抗剂;(iii)高压氧疗法;或(iv)人脐带血细胞移植。5. 此外,在开始热应激之前,发现采用以下措施之一进行预先处理能够预防热射病反应:(i)全身给予α-生育酚、甘露醇、诱导型一氧化氮合酶抑制剂、μ-阿片受体拮抗剂、内皮素ETA受体拮抗剂、5-羟色胺能神经耗竭剂或受体拮抗剂,或谷氨酸受体拮抗剂;或(ii)热休克蛋白72预处理。6. 有确凿证据表明,脑血管功能障碍是热射病治疗中一个有吸引力的靶点。

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Cerebrovascular dysfunction is an attractive target for therapy in heat stroke.脑血管功能障碍是中暑治疗中一个有吸引力的靶点。
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